| NPI | 1255304762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 11841) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MN 11841) |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2024-09-18 |